Wisconsin-illinois Senior Housing

NPI 1649264623 - Skilled Nursing Facility - 314000000X

NPI Details
NPI 1649264623
Enumeration Date 09/07/2005
Last Updated 03/19/2013
Entity Type Healthcare Provider
Active Over 11 years ago
Authorized Information
Name SCOTT SCOTT
Position NURSING HOME ADMINISTRATOR
Phone (920) 622-4342
Fax (920) 622-3655
Practice Location
425 SUMMIT ST
WILD ROSE WI, 54984-6804, US
Phone (920) 622-4342
Fax (920) 622-3655
Business Location
425 SUMMIT ST
WILD ROSE WI, 54984-6804, US
Phone (920) 622-4342
Fax (920) 622-3655
Toxanomy
Taxonomy Code 314000000X
License State Wisconsin
License Number 2606
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According to our database, Wisconsin-illinois Senior Housing NPI is 1649264623, taxonomy code is 314000000X and license number is 2606, license state is located at Wisconsin. Wisconsin-illinois Senior Housing physically located at 425 Summit St, Wild Rose WI, 54984-6804. NPI Number 1033115704 has the healthcare provider type.

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1649264623 NPI number is provided on an as is basis without warranty of any kind. 1649264623 is maintained by the National Plan & Provider Enumeration System. The contents of Wisconsin-illinois Senior Housing are for informational purposes only.